Tamil Nadu is in the peculiar situation of having a CM who is hospitalised for more than two weeks now, with no interim CM

Saturday evening's medical bulletin on Jayalalithaa introduced a new term - Passive Physiotherapy - to the people of Tamil Nadu, eager to know the daily status of their chief minister. As the term indicates, passive physiotherapy is when the patient is too weak or unable to perform certain exercises meant to keep the muscles taut and in good shape and the patient needs help to do that.

Doctors say this indicates the CM is perhaps not conscious and since she has been completely still on the hospital bed for more than two weeks, passive physiotherapy is to exercise the muscle. The process also involves tapping on the chest to dislodge secretions and get them out of the body.

The medical press release also said that `the respiratory system is closely watched and adjusted'. On Friday, sources reveal that tracheotomy was done on the CM, which means that the oxygen supply that all these days was given through the mouth, is now being given directly through the trachea.

There is no clarity on why this decision to shift the endotracheal tube was taken. Was it because giving oxygen through the mouth for a long period was leading to ulceration at the back of the tongue?

Or was it because as medical experts say, the oxygen supply is better controlled if given through trachea. If the wind pipe is blocked, it is easier to clear it through the trachea.

Or have there been instances where Jayalalithaa has regained consciousness. Doctors say if the patient is awake even to an extent, she will find the tube going through the mouth very inconvenient and is more than likely to pull it out.

The last possibility gives rise to more confusion. Oxygen supply is usually given through the mouth if hospitalisation is for short periods of time. Taking the trachea route apart from other reasons, also indicates a longer stint on outside respiratory support. Is this an indication of Jayalalithaa's real health condition?

But even as Jayalalithaa continues to be under observation and treated for lung decongestion, the feeling that Tamil Nadu is also slipping into an Intensive Care Unit like situation is developing. Not that the systems have broken down or there is an issue of law and order. But Tamil Nadu is in the peculiar situation of having a CM who is hospitalised for more than two weeks now, with no interim CM and an acting Governor in Vidyasagar Rao (who is Governor of Maharashtra). Opinion on the street is that this is not the recipe for good governance.

Sources indicate that while people outside the AIADMK, especially the opposition and political observers, suggest that the ruling party appoint an interim CM till such time that Jayalalithaa recovers, those within the dispensation are fighting shy of throwing their hat into the ring. This does not mean that no leader wants the short-term top job. Everyone is apprehensive how Jayalalithaa will react once she recovers and finds out that xyz leader was more than enthusiastic to take her job.

Given the power structure within the AIADMK, it is also about what Sasikala, Jayalalithaa's trusted aide has in mind. The senior lot in the AIADMK also fears that the knives will be out for the person who indicates a desire to be interim CM. Ambition has never been a virtue in Indian politics. In the AIADMK, it is a banned word.

Add to this the vertical divide in the AIADMK on caste lines. The Thevar community is the dominant group, to which Sasikala and O Panneerselvam, former CM belong. But the Gounder and the Nadar community legislators are not keen to let the Thevars control the party and the government. The ferment within the AIADMK means it will be very difficult to find a candidate acceptable to everyone.

In that scenario, it is more likely that Jayalalithaa's two key portfolios of Home and General Administration will be divided between two senior ministers, finance minister O Panneerselvam and PWD minister EK Palaniswami. Jayalalithaa could then continue to be CM without portfolio.

As things stand today, it seems unlikely but if a situation of a contest of sorts arises, Rahul Gandhi's eight Congress MLAs could come in handy. The Congress Vice-President's visit has already opened the channels of communication between the Congress and the AIADMK. Given that Tamil Nadu Congress chief S Thirunavukkarasar is a Thevar, it is anyone's guess which side the Congress will bend towards. Also Thirunavukkarasar has been a part of the AIADMK apparatus before, having worked with both MGR and Jayalalithaa and would find it easy to do business with the party, if that is the political path Rahul has in mind for the Congress in Tamil Nadu.